New Therapies in Irritable Bowel Syndrome: What Works and When

Orla Craig


Curr Opin Gastroenterol. 2018;34(1):50-56. 

In This Article

Pain in Irritable Bowel Syndrome

The pain of functional gastrointestinal disorders including IBS can often be one of the most difficult symptoms to treat. Although some of the newer agents discussed have beneficial effects on abdominal pain associated with an erratic bowel habit, they are often ineffective wherever pain is the predominant problem. An antispasmodic, followed by a TCA is generally recommended wherever pain is the predominant problem but TCAs are frequently poorly tolerated. Although studies of central neuromodulators other than TCAs and SSRIs are lacking in IBS, studies in other painful somatic disorders such as diabetic neuropathy, fibromyalgia and chronic musculoskeletal pain suggest that Serotonin and Noradrenaline Reuptake Inhibitors such as Duloxetine or second-generation antipsychotics such as Quetiapine may have a role in this patient group and that augmentation therapy may be of benefit.[11,42]